Friday, April 28, 2017

Mississippi Today reported that Mississippi Baptist Health Systems is merging with its cousin in Memphis:

The trustees of Jackson-based Baptist Memorial Health Systems voted
Tuesday to finalize the merger with Baptist Memorial in Memphis,
according to two sources within the hospital.

The merger will bring together two of the biggest hospital systems in
their respective states. Mississippi Baptist encompasses four hospitals
and a handful of other health care services across the state and
employs more than 3,700 health care professionals. Memphis Baptist
includes 17 affiliate hospitals, six of which are already in
Mississippi, and employs more than 14,000 people.

On September 30, 2016, the System entered into a Letter of Intent with Baptist Memorial Health Care Corporation (BMHCC) with the purpose of merging the two institutions. The form of the transaction will involve BMHCC becoming the sole member of MBHS, with the current Trustees of MBHS or other persons chosen by the Board of Trustees of MBHS joining the Board of Directors of BMHCC. Due diligence procedures and negotiation of the definitive agreement (Shared Mission Agreement) are presently underway and expected to be completed in February 2017. In the event the System and BMHCC enter into a Shared Mission Agreement, the closing will be subject to customary closing conditions and certain governmental and other approvals. There can be no assurances the parties will execute the Shared Mission Agreement or the closing will occur. It is anticipated that the closing will occur by April 30, 2017.

The Health System’s financial performance for the six months ended February 28, 2017 is summarized in Table 3 below. This table shows year-to-date operating loss of $6.7 million and operating EBIDA of $13.4 million.* Net operating revenue decreased 1.7% over prior year, and under budgeted growth by $10.9 million. Actual inpatient volume as compared to budgeted volume for the Medical Center was ahead of budget by 264 admissions and ahead of prior year by 402 admissions. Outpatient volume was above budget expectations and above prior year. Actual non-capital operating expenses are below both budgeted expectations and prior year. Actual capital related expenses are below prior year and budgeted amounts. This resulted in an operating loss of $6.7 million for the February 2017 year-to-date financial performance as compared to a budgeted loss of $1.2 million. The non-operating gain is $17.2 million versus the budgeted gain of $5.3 million and the $12.0 million loss in the prior year. Included in this line item are year-to-date realized investment gains totaling $1.3 million, unrealized investment gains of $6.9 million, and a $9.7 million positive change in valuation of the fixed payer swap transaction entered into in March 2007.

However, the operating loss also includes a $15 million expense for depreciation. Thus cash flow was actually positive. The revenue was higher than the same period from a year ago but lower than the projected amount. Admissions increased by 302 patients from the previous year as well.

Brilliant move that makes great sense in many ways. Good from a business model. Great from the perspective of combining cultures with a shared Christian mission and vision. This won't be perfect, but things will be better for Mississippi's patients and families because of this.

As both entities are 501(c) organizations, there are no shareholders or owners that will get rich as a result of the merger as would occur in the merger of two for-profit corporations. That being said, is it entirely possible that the BOD of one or both organizations have put in place a bonus plan for their execs that will reward them if the merger is completed. The administrators of these non-profit hospital systems do pretty well: Chris Anderson, CEO of MBMC made over $600K in compensation in 2015. Jason Little, the CEO of BMH in Memphis made over $1M in that same year.

No doubt there will be some very large legal fees and probably advisory fees paid out to consummate the merger as well.

If they (Baptist) don't get rid of people like Mike Stevens the whole thing will implode. Baptist Jackson is so heavy in real estate holdings that it can't move. I would guess they have $20,000,000 in land that has not been developed and probably won't. I've seen donated property in the millions of dollars that literally mildewed to a point it could not be used.

Baptist is actually well managed. And the properties they purchased were investments for the future, some pan out, some don't. Compare their management to, say, UMC... $70 million in the hole, bloated administration, mass exodus just beginning or the Merit hospital system... all 5 hospitals are for sale and only 1 of the 5 made any money last year. Though not perfect, this will most likely secure Baptist's future for the next 20+ years and with the addition of EPIC and economies of scale, will make Baptist the provider large insurers want to do business with (Remember when UMC told BCBS to pay us like we're Vanderbilt but BCBS said you're no Vanderbilt!). This is happening all over the nation... there have been dozens of major consolidations all over the country. Get big or die it seems. I've said it before... St. D's is the odd man out. Smart, hard working people at St. D's but they are really behind in the game. Baptist started its primary care network over 20 years ago. St D tried to build theirs by buying MEA, but we all know, MEA is not primary care and now they are scrambling to build the primary care+ clinics. TrustCare is the wildcard but so far all they are doing is siphoning the cream from MEA (and to some degree Baptist) but their business model is a lot like MEA's (or really, more like ValueJet's).

Chris Anderson left a huge mass of financial destruction in his wake when he bolted from Singing River Health System. Just ask their retirees or their multiple sclerosis patients. They can fill you in on the blessed work of Mr. Anderson. Why Baptist hired him and kept him on for long is still one of life's great mysteries. Guess it does pay to be in the "in" crowd. You're rewarded handsomely even when all you produce is one failure after another.

Interesting posts. As one who has used MEA clinics personally and in a business sense for 25 years, what do you see as the future of that group, or does it have a future? If not primary care, what is MEA other than a place to get a shot for the flu or a note to excuse one from work?

Really, the most complicated thing they seem to do there is make referrals to other medical facilities with whom they are affiliated or financially tied. Doctors at these places are part owners of MRI machines and other fancy equipment which provide, to them, a quarterly or annual check. They will refer you to high-dollar specialists who own condominiums in Denver and Destin. Baptist aside, what is the future of MEA (and other Doc-In-The-Box scams) in your opinion?

Up to this point, and probably for the foreseeable future, doc-in-the-box clinics are pretty much what you've described: a feeder network for larger health systems to acquire patients who will presumably consume higher-priced, higher-margin services. There has been a proliferation of this model across most markets over the last decade, and the valuations for these businesses has gotten frothy.

Long-term, there could possibly be a broader and more value-added role for the doc-in-a-box clinic. A larger network of more easily accessible clinics has the potential to provide more frequent, lower-cost services that help maintain health rather than treating people who are already sick. Possibly the best example would be diabetes patients. If a diabetic has a walk-in clinic around the corner that can do quick, 15-minute basic exams frequently to ensure that the patient is complying with med therapy, diet, etc, they are more likely to drop in than if they have to set an appointment with their doc that may be at the med center or in any other less-convenient location. Beyond diabetes, there are conditions like obesity, heart disease, hypertension and others that could benefit from this model.

Alas, most physicians and health systems are still dependent upon the high-dollar services like imaging, surgeries, etc., so the idea of any sort of wellness-oriented services is probably a long way off.

Who is the Hottest Reporter in Jackson?

Trollfest '09

Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything). Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.

Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".

In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up. In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.Note: Security provided by INS.

Trollfest '07

Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!